New graduate nurses’ professional becoming: A study of lived experience

The first year of sustained practice for New Graduate Nurses is a significant period of professional growth and development. Having never been registered nurses, New Graduate Nurses are simultaneously being and becoming registered nurses. This qualitative study aims to contribute to a deeper understanding of New Graduate Nurses’ experiences of professional becoming. Nine New Graduate Nurses participating in Transition to Practice Programs at three regional Victorian health services between 2013 and 2014 volunteered to share their experiences for this study.
Hermeneutic phenomenology was chosen to explore participants’ lived experiences and to answer the question:
• What are the experiences of New Graduate Nurses that shape their professional becoming?
To answer this question the following sub-questions were posed:
o What enables and constrains New Graduate Nurses’ professional becoming?
o What do New Graduate Nurses’ experiences mean for their care and caring practices?
Data was collected from participants using three methods: i) two semi-structured interviews, the first of which included visual elicitation; ii) participant observation; and iii) a participant creative artefact. Three artefacts were chosen to provide a basis for initial data analysis and are re-presented in the findings chapters in this thesis as ‘metaphor made real’.
New Graduate Nurses encounter an avalanche of newness upon commencement of their employment, which can contribute to a cognitive busyness which constrains their professional becoming and leads to cognitive short cuts. Calming cognitive busyness is neither time-bound nor linear.
As they begin to feel more in control, New Graduate Nurses’ busyness subsides and they begin to ‘see’ patients’ responses to their own situations. Their professional nursing responses become commensurate with their education and experience. This shift in attention can create professional and personal tensions. Tensions come from the intimate, privileged nature of nursing work that is beyond social norms of relating to strangers. Time to gain experience in their new roles and contextualise their experiences is important for their practice and for New Graduate Nurses as people.
The intra-professional environments New Graduate Nurses enter are revealed in their experiences of work unit cultures and broader professional discourse. Systemic and endemic tensions within the profession’s discourse about New Graduate Nurses’ preparation for practice are beyond their control. Yet they bear the burden of deficit views about their professional capabilities. Collectively supporting their professional development to become practitioners capable of providing integrated, skilled and embodied care is a professional imperative.
New Graduate Nurses learn about themselves as people. The personal changes they experience are significant to their professional becoming because their encounters in practice impact them personally and professionally. Integrating their role as a registered nurse within their broader life is a feature of professional becoming that requires navigation of uncomfortable silences.
Literal, epistemological and ontological silence reflect personal discomfort and private efforts to ascribe meaning to professional experiences. Through reflexivity, opportunities to question and challenge assumptions and biases during self-evaluation and self-critique can move New Graduate Nurses beyond improving direct patient care to knowing oneself in practice by returning to ‘being’ and (professional) becoming.